+44 1518081136Prevalence and factors associated with hydatidiform mole among patients undergoing uterine evacuation at Mbarara regional referral hospital
International Conference on Pathology and Surgical Pathology
September 06-07, 2018 | Edinburgh, Scotland
Olivier Mulisya, Drucilla J Roberts, Elizabeth S, Elly A, Damaris L, Tusabe T, Mpiima D, Lugobe H, Ssemujju A, Masinda A, Twizerimana H and Julius M
FEPSI, DR Congo
Posters & Accepted Abstracts : J Pathol Dis Biol
Abstract:
Objective: We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH) Mbarara, Uganda. Methods: This was a Cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for non-viable pregnancy were included. The study registered 181 patients. Data was collected on socio-demographics, medical conditions, obstetrics and gynecological factors. The evacuated tissue received a full gross and histopathologic examination. Cases of pathologically suspected complete hydatidiform mole were confirmed by p57 immunohistochemistry. Data was analyzed using STATA 13. Results: The Prevalence of hydatidiform mole was 6.1% (11/181). All detected moles were complete hydatidiform moles, there were no diagnosed partial hydatidiform moles. Clinical diagnosis of molar pregnancy was suspected in 13 patients but only 69.2% (9/13) were confirmed as molar pregnancies histologically. Two cases were clinically unsuspected. Factors that had a significant relationship with complete hydatidiform mole included maternal age of 35 years and above (aOR 13.5; CI: 1.46-125.31; p=0.00), gestational age beyond the first trimester at the time of uterine evacuation (aOR 6.2; CI: 1.07-36.14; p=0.04) and history of previous abortion (aOR 4.3; CI: 1.00-18.57; p=0.05). Conclusion: The prevalence of complete hydatidiform mole was high at 6.1%. Associated risk factors included advanced maternal age (35 years and above), history of previous abortions, and gestational age beyond the first trimester at the time of evacuations. Recommendations: We recommend putting in place capacity to do routine histopathological examination of all products of conception especially those at high risk for a molar gestation either by clinical suspicion or risk factors including advanced maternal age, advanced gestational age, and history of previous abortion because of high prevalence of complete mole. We recommend a cohort study aimed to determine risk factors of hydatidiform mole and to determine the outcome of patients with hydatidiform mole undergoing uterine evacuation at MRRH.
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